NPI | 1063764017 |
---|---|
Former Name | FELICIA COFFMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 55426) |
Additional Taxonomies | 104100000X Social Worker (Licence: TX 55426) |
Enumeration Date | 2012-10-15 |
Last Update Date | 2016-02-10 |